Do you guys have Pyxis in your hospital?

Crux1024 · Mar 2, 2010

I believe our policy is supposed to be one pt at a time, but I know several people who will take out 2-3 pts meds and then have to walk to the opposite end of the floor. Done to save time. I do it too sometimes since we only have one pyxis and its near the elevators.

I cant remember a time when the hospital audited when meds were removed for who and when given. This hospital has had pyxis for years though. I think people are just used to it.

BTW, we STILL wait for pharmacy to send user specific meds to our floors. And also wait for them to refill the pyxis at times.

Bobylon · Mar 2, 2010

Perhaps my hospital is a lil different - our Pyxis system is for stuff other than actual pills/meds (nonskid socks, specihats, iv stuff, tape, dressings, etc, etc, etc.) We have "AccuDose" for dispensing meds....our system allows us to get out meds for multiple patients, just that they must be given within 30 minutes of taking them from the system. Works well in most instances...

lambimari · Mar 2, 2010

We use to have accudose but pyxis replaced it this past week...They're essentially the same thing - pyxis can store a lot more meds and it looks more impressive I suppose...

Pyxis will let you take out meds for all your patients at one time...the problem is that hospital policy says we can't God, admins are so stupid!

lambimari · Mar 2, 2010

We're having some issues too...like the medication is in the pyxis but it isn't showing up at all under the patients profile OR stupid thing will freeze [and they're brand new too!] *sigh*

Michael A RN · Mar 2, 2010

We have MedSelect, which is another brand. You can only take one patient's meds out at a time, but you don't have to leave the machine or logout to choose another patient and get their meds. I only have 2 patients per shift so it is easy to keep the meds I take out straight and we have 3 machines in our unit. I work ICU and the issue we have is overriding meds. We have been repeatedly told that our override priveleges will be taken away if we do not get an order for the meds and fax it to pharmacy after using them. I agree that the order is important, but my priority is not always faxing the order immediately. The meds I am overriding are typically for procedures or emergencies. The other thing that is a problem is responding to rapid responses. We do not have access to the MedSelects on other floors so we have to find a floor nurse to get the meds we need and the machines are not always stocked with the meds we might need, like pressors. On the whole the machines aren't bad, and you get use to them, but they do have their drawbacks.

NurseStephRN · Mar 2, 2010

we have pyxis at my hospital and what my routine is this:

get report, do assessments and vitals, check charts for new orders, go to pyxis and pull out meds. i DON'T pull meds for one patient, pass them, then go back to the pyxis for the next patient, etc... it's a waste of time and makes no sense to me. yeah it's supposed to be safer, but what's to keep u from taking meds for one pt and going to the wrong room/bed and giving the wrong meds? our pharmacy provides us with plastic baggies (some nurses use biohazard bags even though we're not supposed to, lol) and what i do is write the room/bed number on the bag and make one for each patient.

when there's a med that is not in the pyxis (pt specifics) the pharmacy gives us a pre-printed label with the patient's info, med info, MD info, etc and i use that instead sometimes.

enjoy the pyxis!

carolinapooh, BSN, RN · Mar 2, 2010

I hate to say this, but I can't imagine why you'd pull more than one patient's meds at a time. You don't look ridiculous - you look safe and smart.

I've never worked anywhere that didn't have a Pyxis, and I've never seen anyone pull more than one patient's meds at a time - and I've had as many as seven oncology patients on a night shift. I can also honestly say I've never walked into a patient's room with the wrong medications (i.e., Patient Y's meds going into Patient X's room), and I can assure you I'm not perfect. I've had a med error - because I missed an order, not because I went to the wrong room with the wrong meds (which it would seem to me is ten times more likely if you're pulling meds for multiple patients at once).

Why would you put meds in plastic baggies? There's an awful lot of wasted time sorting meds and labeling them right there...

These are questions, not judgements, because I don't understand how this saves time or prevents errors. It goes against everything I've ever seen, was ever taught, or can even comprehend.

carolinapooh, BSN, RN · Mar 2, 2010

Pyxis will let you take out meds for all your patients at one time...the problem is that hospital policy says we can't God, admins are so stupid!

I have my problems with administration, but it would seem here the rule is to keep someone from inadvertently injuring - or worse, killing - someone. I would imagine that's why the rule's there in the first place.

GooeyRN, ADN, BSN, CNA, LPN, RN · Mar 2, 2010

We have to pull them one by one and then put them into a med cart to then pull again. We are told we HAVE to use the med carts, we can't just pull them one by one. I hate it. I feel like I am passing meds twice for every pass. Of course someone from pharmacy comes to fill the med carts on days, but do you think that happens for the night shift? um, no. And our med pass is just as heavy. :mad:

My other job also uses a pyxis, but it hardly ever has new meds we need. We still have to wait, I don't see the point.

RNKPCE · Mar 2, 2010

Have used Pyxis forever it seems for both meds and supplies. We use to pulls meds for more than one person but not anymore. This is a med safety issue. Less likely to give wrong med to wrong patient if you only have one patient's meds.

They can and have done tracers and they can see that you logged onto computer and pulled meds for Mrs. Smith from pyxis then shortly after you logged onto computer in Mrs. Smith's room and gave meds. Then you came back and did the same thing for Mr. Jones. But if they see that Nurse Nancy pulled meds for Mrs. Smith and 1 minute later for Mr. Jones and then you charted on Mr. Jones and then Mrs. Smith they know you went against hospital policy. They can even get you for carrying a med too long before you give it. You can be disciplined and/or terminated for not doing it according to policy.

zofran · Mar 2, 2010

I have to agree with carolinapooh....have never used anything other than pyxis and cant imagine pulling out multiple pt meds at one time. It just becomes routine...pull the meds, give them, then go back to pyxis and repeat for the next pt.

Our new thing now though is scanning the meds...OMG its a pain...I am still trying to get used to it. No more running in and hanging a bag of fluids or giving a quick vicodin. Now we have to pull up the MAR in the room, scan the pt wristband, then scan the med. Oh lord...my 1000 meds got done at 1130 today.